'Shaking Hands With Death'

I just watched this year's Richard Dimbleby Lecture, which is a lecture given by a prominent figure on a topical issue each year in the memory of the BBC broadcaster Richard Dimbleby.

The lecture was entitled Shaking Hands With Death and was by the author Terry Pratchett on the topic of what he calls assisted death but is probably more commonly referred to as assisted suicide or voluntary euthanasia, a topic that has got a lot of coverage on the back of the Dignitas Clinic in recent years. It's also a topic of personal interest to Terry Pratchett because he has a form of Alzheimer's disease, which is currently incurable. You can read a (very) abridged and edited version of the lecture here, or watch on the iPlayer if you're in the UK.

It was a bold, moving, thoughtful and funny piece that argued "My life, my death, my choice" and that a person should be able to chose to die a medically assisted death when suffering a debilitating and incurable illness. And...well, I find it very difficult to argue with that and thought it would be interesting to see if anyone here does. There are religious concerns, I understand, which is not something I easily sympathise with and also the argument that palliative care is always a superior alternative to letting someone die even if they wish to. Personally, I wouldn't feel qualified to say that what I think best overrides someone's decision when they are in that situation and that their choices - provided mental competency is established - should and must be respected. It seems the humane thing to me.

In my opinion on this issue, I am a very open person to many things, but things involving life I always take my religion to play. As a Catholic, I feel that life is a gift and since we never know what comes after the eyes close, I don't think that it is right to do so. Sometimes it is hard to deal with some things because the majority of people who do assisted suicide are those who are in ailing or fatal conditions who just want to end it. It is a hard topic to deal with but life is a gift and taking that gift for granted is just too much for me to agree with. There's my two cents.

As a Catholic, I feel that life is a gift and since we never know what comes after the eyes close, I don't think that it is right to do so.

I entirely respect that as a personal standpoint - ie. you would never want to go down the road of assisted death if you found yourself in the circumstance of having a fatal and incurable disease. That's obviously your prerogative and if it's how you feel because of your religious beliefs and ideas of the sanctity of life and what not, that's absolutely fine.

However, do you think that your rules should apply to everyone and that people should be prevented from making their own decisions about this? Because I kind of think it being your prerogative is the central point here; when we're talking about such fundamental decisions concerning an individual's life and very existence, how can one say that the decision should not up to the individual?

I believe that life is a gift, but I also believe that death is a gift as well. There are some diseases which are horrible to endure. Some cancers are so painful, that the patients are so doped up that they basically sleep the rest of their lives away. Towards the end, the hospital gives them that last push of morphine.

ALS is also a horrible debilitating disease. Towards the end, the victim is completely paralyzed, yet their mind is intact. They are a total burden on their care givers. The disease still kills them. How can this kind of life be precious? I don't believe for a moment that God wants people to suffer this way. If it wasn't for the intervention of medicine, they would have died long before it got to that point.

Part of the problem is that we play God by keeping dying people alive when they would have died sooner had their been no intervention. It's one thing if a person can live a normal useful life, but quite another if you are only buying a few month of suffering. And if one believes in life beyond this one, why wouldn't you want to go to it. After all, that life is for all eternity, or so many of us believe.

I'd take it one step further. What if life is emotionally unbearable. Does that person have the right to move on into the next life? There are so many degrees of suffering, and this world is becoming harder to deal with. The gift of life is one of suffering, or at least it is for me most of the time. Who's to say the next life isn't much better. And if there is no next life, then what does any of this matter? How can living a few more months or a few more years matter compared to eternity?

It's for that very reason that I believe there is life after this one, but that also makes me long for the next life. I've clinically died twice, and each time I was in a place of light and of overwhelming peace. Oddly enough, no one threatened to eliminate my job, cut me off in traffic, deny me health care, send my job overseas, or make political decisions that make my life miserable.

Life is a gift because it gives us being, but how do we use that gift? Until we realize that we should work for better things, work for each other, make the world a better place, and love each other as much if not more than we love ourselves, we will never advance, and the gift will be wasted. When the gift is wasted, life has little meaning.

Well, as a fellow Catholic myself, I agree with tk. Every life is a gift from God, and I truely feel sorry for those that can't seem to understand that. We must realize that God makes no mistakes. He does everything for a reason, which, trust me, I know, can be extremely hard to understand. But to go and do something like this, I guess I just can't understand the reasoning in it. Who's to say that the person who follows through on this action, that they next day they find the cure for there cancer, or have a donor for the organ they need? Is it likely, probably not, but is it possible? Absolutely. I believe that with prayer, anything is possible. Assisted suicide only brings the end faster. Why not live each day for what its worth? We only have so much time here. With modern medicene, they are finding cures every day for different diseases. Who knows, maybe that next day could've that persons lucky day

i'm agreeing with dogboy on much of this. and i have to wonder just how big (widespread) of an issue it is that it needs to be addressed by legislation? i mean, DNR (do not resuscitate) is routinely put on the medical notes of terminally ill patients in hospital and it's also a well known 'secret' that medical staff will hasten death in order to prevent further suffering. to my mind, the issue being presented is a much more selective one of choosing suicide before or upon the onset of debilitating symptoms with a medical assistance. and that gets me wondering because, in all truth, when it comes time for me to pass on, i want to be in the position where i'm so miserable and pained that i really want to die or that i just don't care one way or the other (i'm sure we've all experienced that feeling during illness); i wouldn't want to think about it until i got to that point. so, i find it a bit strange that some people can find the spirit and well-being to travel abroad in order to seek a MAS.
and there are many ways to commit suicide without involving others.

Actually, as an atheist I find the moral dilemma quite hard too, especially since I do not believe in an afterlife.

However, when a person is only kept alive, and has no chance to be saved, then I think that the patient should be allowed to die, as long as its something that has been tough trough (psych examination, at least two independent doctors determining that the illness is terminal, waiting period). I'm ok whit euthanasia, it just better be a trough process to go trough, to make sure it is indeed the wish of the patient, and that it is medically advisable.

Now, chronic illnesses is another can of worm... Much more interesting (and frightening, imho).

I haven't watched this programme yet, as I'm waiting for it to be available on iPlayer in HD, but I will watch it as soon as it's available.

That said, I've felt very strongly about this topic for quite some time - even before it started affecting Pratchett directly (I've always been a massive fan of his ).

If someone genuinely, truly wants to die, and is in a sound state of mind when they make that decision, I don't see why anyone else should be allowed to stop them from doing so. It's their own life, after all, isn't it? I can't help but feel that family members going against relatives' wishes, and keeping them alive when they don't want to be kept alive, is just a case of the family members being selfish (not wanting to personally deal with the grief of losing a relative) or cowardly (not wanting to be "the one who made that decision"). But they're doing so against the express wishes of their loved one, which doesn't sound particularly loving to me.

As far as the medical side of it goes, we already have DNRs, so what difference is allowing someone to die? We're talking about assisted suicide, here; about situations where the patient in question is no longer physically or mentally able to kill themselves. Surely by that point they would also no longer be capable of keeping themselves alive, and essentially have their family or medical personnel keeping them alive for them. How does that really differ from keeping someone alive or resuscitating them for more immediately terminal problems?

Of course, by the time you are in the situation where you would no longer be able to commit suicide yourself, there's also a fair chance that you wouldn't be in a sound state of mind to make the decision to let someone help you with it. But, again, we have living wills for that. State ahead of time that once you get to a certain level of incapacity, you wish to have your life ended painlessly and peacefully.

And it's the "painlessly and peacefully" bit that Pratchett seems most interested in (from what I've read & seen of his talks on the subject in the past), along with the issue of not burdening his family for what, to me, would seem like essentially no reason. I mean, his Alzheimer's isn't going to be getting better, and eventually he will have lost so much of his mind that he becomes just "something that's being kept alive", and largely without any kind of mind left. It sounds heartless, I know, but it's the case with a lot of illnesses by the time they get to that stage. If I was in that situation, where I needed someone to care for me 24/7 with no chance of recovery, I would want to end it as soon as possible. There's absolutely no point being kept alive for the sake of being kept alive, especially when you're being left in either physical or emotional pain (from watching your relatives spend all of their time looking after you). Just get my family & friends together, say goodbye to them all, then give me enough sedative to send me (painlessly) into a sleep from which I never wake. Sounds like a decent enough ending to me - far better (and far more dignified) than spending several years being unable to do anything for myself.

It's an individuals choice. If you are religious, you are entirely within your right to believe that suicide or assisted suicide is wrong. However what you can't do is stop other people from enjoying the right to assisted suicide. You can tell them that it's wrong or sinful, but you shouldn't be able to stop them from doing it. An individual owns their own body, not the clergy and not the hypothetical creator of the universe until proven otherwise.

It's okay saying life is a gift, but it's not a gift that a baby dying of cancer asked for. If I bake you a really crap cake that tastes like raw sewage you aren't obliged to eat it, you can put it in the bin. When I ask you why you threw my gift away you can tell me that quite frankly it tasted foul. I might be a bit offended but one positive to come of it is that I would try to improve my cooking skills.

Individuals choice. The thing that concerns me is what we term as illness. I agree with it in the terms of crippling illness's that destroy the body. But I would disagree in the cases of severe depression and other psychological illnesses.